Agent | Continental Travel | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 010 | ||||||||
Effective Date | 04/07/2018 | ||||||||
Expiry Date | 04/22/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Johhanes Chifundo Kumpata | ||||||||
Policy Number | 089 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | Netherlands | ||||||||
Address | C/O CONTINENTAL TRAVEL AND TOURS | ||||||||
Number of Passengers | ONE | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 38,637.76 | ||||||||
Total Premium (After Tax) | 45,012.99 | ||||||||
Signed by |